DOWNTOWN NEW HAVEN, 2008. Nobel laureates and esteemed university professors mill about in the lobby of a large Yale research building. Standing in the center of the foyer is an unassuming man, frail and wearing thick-framed glasses, who shies away from the handshakes.

At age 88, Raymond Sackler had amassed wealth that would have made the Vanderbilts green-eyed: his family’s net worth now stands at 13 billion dollars. The ceremony honored Sackler’s multimillion-dollar gift, which established the Raymond and Beverly Sackler Institute for Biological, Physical and Engineering Sciences at Yale University.

Yale School of Medicine Dean Robert Alpern recognized the Sacklers’ “commitment to advancing science” as “impressive and inspiring.” But Alpern did not mention the more contentious element of the Sacklers’ legacy: their role in the opioid crisis, which many doctors and advocates believe began when the Sacklers’ company, Purdue Pharma LP, started misleadingly marketing dangerous opioid painkillers in the late 1990s.

The Sackler family’s public image is caught in a tug-of-war between its philanthropic generosity and its role in initiating the opioid crisis. As evidence of the family’s charitable giving, the Sackler name is inscribed in a Yale institute and two endowed professorships. But unlike another Yale institution whose name has been questioned and changed—Grace Hopper College, which was named after slavery advocate and Vice President John C. Calhoun (YC 1804) until 2017—the Sacklers’ gift has gone largely unnoticed, despite the family’s divisive legacy.

Few Yale students know who the Sacklers are, let alone criticize their controversial business. Patrick Radden Keefe LAW ’05, the New Yorker staff writer who investigated the family’s links to the opioid crisis in October 2017, believes the silence may be related to the Sacklers’ donor potential. “Perhaps it’s because the Sacklers, unlike the Calhoun family, still have a fortune to give away,” he wrote in his article.

Yet the consequences of the Sackler family’s misdeeds continue today: 49,000 people died in 2017 alone from opioid abuse.

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Purdue Pharma LP has built an empire revolving around pain management medication, branding itself a “pioneer in developing medications for reducing pain, a principal cause of human suffering.” Its website is filled with images of smiling patients and physicians; the top of the screen reads, in bold white lettering, “a positive impact.”

But there is a dark side to Purdue’s pain pills. Released by Purdue in 1996, the drug OxyContin was approved by the Food and Drug Administration to treat “moderate to severe pain.” Now, it is infamous as one of the key causes of opioid drug abuse. Mike Moore, a former Mississippi attorney general who is leading a new, multi-state suit against Purdue, told The Politic in an interview that in its advertising, the company “minimized the dangers of addiction, which was one of the major causes of this opioid epidemic.”

According to Kolodny, heroin and oxycodone, the active ingredient in OxyContin, produce indistinguishable effects on the brain. After becoming addicted to prescribed OxyContin, patients often transition to non-prescription drugs like heroin and the even-deadlier fentanyl—another opioid 100 times more potent than morphine—when physicians discontinue their prescriptions.

When Purdue released OxyContin in 1996, it simultaneously launched a multifaceted campaign to misinform the medical community about opioids’ risks, Kolodny said.

Purdue hired prominent pain specialists to exaggerate the problem of untreated chronic pain and to overstate the supposed benefits of using opioids to treat patients’ pain. The American Pain Society, which received large donations from Purdue, published research supporting the use of opioids to treat pain of all severities. And as physicians bought into the campaign, the prescription of opioids soared into today’s public health catastrophe.

Over 200,000 Americans have died from overdoses related to the misuse of OxyContin and other prescription opioids since 2002. Four in five people who try heroin today have previously used prescription painkillers, and 115 Americans die each day from opioid overdoses.

“The Sackler greed led to tremendous pain and suffering and loss of life,” Kolodny said. “They created a very expensive problem in some communities. They’re running out of money for caskets. The medical examiners and coroners are quitting because they can’t handle the workload of opioid-abuse deaths.”

Moore also stressed the massive scope of the opioid problem.

“Let’s just say 100 opioid pills should have been sold to the country,” he said. “Purdue Pharma marketed and sold, instead, 100,000 opioid pills.”

Purdue Pharma is still privately owned by the Sackler family, but the family consistently avoids publicizing its connection to the business. No member of the immediate Sackler family holds an executive position today, although eight Sackler family members sit on the company’s board. Richard Sackler served as Purdue’s president from 1999 to 2003, when OxyContin sales were at their peak.

“The Sackler family owns this company,” Moore explained. “I can promise you, if I owned a company and was making billions of dollars, I think I would probably know a little bit about it and about what was going on with my number one blockbuster drug.”

Raymond and his older brother Mortimer grew up in Brooklyn in a middle-class family. They trained as physicians and later developed what has become one of the world’s most successful pharmaceutical companies. Forbesreported in 2016 that the Sacklers were the nineteenth richest family in America. Their net worth of 13 billion dollars puts them ahead of some of America’s most famous families, including the Rockefellers and the Mellons.

In 2007, Purdue paid 600 million dollars in one of the largest lawsuits ever against a pharmaceutical firm. Three of its top executives, none of whom were Sacklers, were found guilty of misinforming physicians and government officials of the drug’s addictive potential.

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Nine years after Yale established the Sackler Institute, it renamed Calhoun College. The Committee to Establish Principles on Renaming determined that no Yale building should bear the name of John C. Calhoun, whose principal legacy is his fervent promotion of slavery. This set a precedent for future cases in which a namesake’s legacy conflicts with the university’s values.

Lynne Regan, a professor emeritus of biochemistry and former director of the Sackler Institute, told Esquire journalist Christopher Glazek ’07 GRD ’07 last year that neither students nor faculty have ever brought up the OxyContin connection.

“Most people don’t know about that,” she said in the interview. “I think people are mainly oblivious.”

“Purdue Pharma’s been mentioned as a link in the progression [of] our current opioid epidemic and a poster child of the consequences of the intense marketing by pharmaceutical companies on provider prescribing,” he said.

Even though some Yale faculty members feel comfortable condemning Purdue Pharma in the classroom, they have been more hesitant in conversations about the Sackler family, particularly in public.

The Politic reached out to Charles Fuchs, MD, MPH, who holds the Richard Sackler and Jonathan Sackler professorship, for comment on the Sacklers’ relation to the opioid epidemic but instead received an email from Thomas Conroy, director of Yale’s Office of Public Affairs and Communications, with a press statement on Yale’s research combating the opioid crisis. The email did not mention the Sackler family. Of the 28 administrators and professors The Politic contacted for interviews, including two that hold Sackler professorships, not one gave comment.

Kolodny believes that if the university wants to help “families who have been affected” by the opioid crisis, “Yale should give the money back to the Sacklers.”